The behavioral-cognitive model of pain.

In the elderly patient, for whom pain can be quite complex and multidimensional, a careful assessment of sensory and psychosocial contributions to the pain experience is important. This analysis will allow for the selection of a comprehensive pain regimen that includes behavioral-cognitive techniques. When carefully chosen, and presented in a manner consistent with the patient's cognitive capabilities, psychological techniques afford the elderly patient enhanced self-esteem and self-control without the addition of potentially harmful side-effects. A discussion focused on normal and abnormal aging processes is intended to assist the clinician in determining the patient's mental status. In normal aging situations, elderly pain patients have been shown to benefit equally to younger populations from behavioral-cognitive techniques, as long as the information is presented in a concrete, well-organized format in relatively brief sessions. Situations involving delirium or dementia pose significant challenges for clinicians and need to be assessed on a case-by-case basis.